Obesity is becoming a growing concern, particularly in the United States, as the number of people with obesity continues to increase and more is learned about the negative health effects of obesity. Severe obesity, in which a person is 100 pounds or more over ideal body weight, in particular poses significant risks for severe health problems. Accordingly, a great deal of attention is being focused on treating obese patients.
Surgical procedures to treat severe obesity have included various forms of gastric and intestinal bypasses (stomach stapling), biliopancreatic diversion, adjustable gastric banding, vertical banded gastroplasty, gastric plications, and sleeve gastrectomies (removal of all or a portion of the stomach). Such surgical procedures have increasingly been performed laparoscopically. Reduced postoperative recovery time, markedly decreased postoperative pain and wound infection, and improved cosmetic outcome are well established benefits of laparoscopic surgery, derived mainly from the ability of laparoscopic surgeons to perform an operation utilizing smaller incisions of the body cavity wall. However, such surgical procedures risk a variety of complications during surgery, pose undesirable postoperative consequences such as pain and cosmetic scarring, and often require lengthy periods of patient recovery. Patients with obesity thus rarely seek or accept surgical intervention, with only about 1% of patients with obesity being surgically treated for this disorder. Furthermore, even if successfully performed and initial weight loss occurs, surgical intervention to treat obesity may not result in lasting weight loss, thereby indicating a patient's need for additional, different obesity treatment.
Surgical procedures to treat severe obesity can affect a patient's hormone levels. It has been noted, for example in Ann Surg (2004) 240: 236-242, that a Roux-en-Y gastric bypass surgery performed on a patient can affect the patient's hormones involved in body weight regulation and glucose metabolism. A number of studies in patients after bariatric surgery suggest that the incretin pathway contributes to improvements in Type 2 Diabetes and to weight loss. Specifically, there are increases in meal-related circulating Glucagon-Like Peptide (GLP-1) levels after surgery, as noted for example in Laferrere et al., “Incretin Levels And Effect Are Markedly Enhanced 1 Month After Roux-En-Y Gastric Bypass Surgery In Obese Patients With Type 2 Diabetes,” Diabetes Care 30: 1709-1716, 2007, and Whitson et al., “Entero-Endocrine Changes After Gastric Bypass In Diabetic And Nondiabetic Patients: A Preliminary Study,” J Surg Res 141: 31-39, 2007. However, so affecting hormonal level effects with surgery incurs the adverse consequences of surgery, e.g., risk of complications, undesirable postoperative consequences, lengthy recovery time, etc.
Accordingly, there remains a need for methods and devices for treating obesity and for methods and devices for affecting a patient's hormone levels.